Everyone has had a sleepless night once in a while, and we all have gone through periods of unwelcome insomnia. But some people have far less good sleep than others. In fact, one-third of adults in the United States report inadequate sleep.
It's well recognized that as we get older, our sleep patterns change. For example, older people sleep less, wake and go back to sleep more often, and spend less time in deep sleep or dreaming than younger people. The shift from deep sleep in earlier years to fitful, dissatisfying sleep can start as early as the 30s, paving the way for sleep-related cognitive and physical ailments in middle age.
Changes in sleep patterns may be a normal part of aging, and among older people, women are more likely to experience insomnia than men. In fact, more than half of people older than 64 years of age have a sleep disorder, often related to life changes such as worry, grief and stress.
As noted in one study, symptoms of insomnia among older adults are associated with a decrease in health-related quality of life. Other factors affecting sleep are the circadian rhythms that coordinate the timing of our bodily functions, including sleep, so that older people tend to become sleepier in the early evening and wake earlier in the morning compared to younger adults.
In a national survey between 2005 and 2010, about 4 percent of adults ages 20 and over reported taking prescription sleep aids in the past 30 days. About 2 percent of people of the youngest age group, ages 20 to 39, reported using sleeping pills, while about 6 percent of people ages 50 to 59 and 7 percent among those ages 80 and over reported the same.
A recent review suggests that restorative, sedative-free sleep may ward off mental and physical ailments. The review, which explored why older adults do not sleep as well as younger adults addressed three questions:
- What alterations in sleep quantity and quality occur as we age?
- Are there functional consequences to these alterations?
- What are the underlying neural mechanisms that explain age-related sleep disruption?
Matthew Walker, a UC Berkeley professor of psychology and neuroscience, and fellow researchers Bryce Mander and Joseph Winer point to studies that show the aging brain has trouble generating the kind of slow brain waves that promote deep curative sleep as well as the neurochemicals that help us switch from sleep to wakefulness.
According to Mander, the parts of the brain that deteriorate first are those that enable us to slip into deep sleep. The slow brain waves and faster bursts of brain waves, or sleep spindles, also known as nonrapid eye movement (NREM), decline with age.
In younger years, our healthy slow waves and spindles help transfer memories and information from the hippocampus to the prefrontal cortex, which consolidates the information, acting as the brain's long-term storage. So, as these types of brain waves diminish, so does memory.
Another deficiency in later life involves the inability to regulate neurochemicals, including galanin (promotes sleep) and orexin (promotes wakefulness) that stabilize sleep and help us transition from sleep to waking states. The result is that we are tired during the day and restless at night.
Although not everyone experiences sleep changes later in life, the popularity of sleeping pills generally increases with age, which supports declining sleep in older adults. The highest use — 7 percent in the past month — is among people 80 and up.
But sedation is not real sleep. The American College of Physicians has acknowledged that sleeping pills should not be the first-line response to sleep problems because they sedate the brain, rather than help it sleep naturally.
Finding better treatments for restoring healthy sleep in older adults is under serious research. Nonpharmaceutical interventions are exploring remedies for better sleep, such as electrical stimulation to amplify brain waves during sleep and acoustic tones that slow the brain.
Researchers contend that improving sleep is a new pathway to extending our health span.
